我校数字化教学的现状与发展趋势

21世纪科技高速发展,计算机和因特网的普及以及数字化技术在医学教学中的应用也将给医学教学过程带来革命性的变化。在信息技术的支撑下,我校加大投入,构建了信息化平台,学校的数字化教学过程有了根本性的变化。不仅使教师的教学形式、学生的学习方式有了变化,而且使教师的角色、素质有了转变,学生的角色、素质发生了根本性的变化,还使我校的临床教学内容在形式上和容量上有了进一步的拓展。     

护患角色体验型教学在股静脉穿刺与鼻饲法中的效果与体会

卫生部颁发的护理学基础高中三年制和护理技术中专三年制教学计划、大纲中都明确规定实践学时与理论学时（除去课间实习）之比为1：1。多年以来，在我校的护理学基础实践教学中为培养学生的专业素质，提高教学质量，凡能够让学生进行护患角色体验的部分全部采用真人实做，即学生之间互相操作。其中皮内、皮下、肌内、静脉注射在学生中相互做已不足为奇，但股静脉穿刺、鼻饲法采用真人实做有一定难度，因为此2项操作会给学生带来较大的痛苦，也给教师的授课增加了难度，同时也有一定的危险性。但通过多年实践，我们感到这些操作尽管给教师的授课带来了一定的难度，但如果能采用护患角色体验型教学则可以使学生在思想上和技术上得到更多的锻炼和提高。     

临床医学导论组织教学探析

为临床医疗本科学生开设“临床医学导论”，在我校实属首次，我们开设此门课程的目的旨在引领医学生早期进入医生角色，明晰人类社会对该职业的期望和要求。使医学生在学习初期就能了解医学相关理论与知识，以现代医学观为指导开展今后的学习。全面的培养和提高自身素质。在参阅大量相关文献的基础上，制作了相关的教学课件并采用多种方法向学生讲述，取得了较好的效果。我们于     

医学伦理学教学中影视作品的应用及体会

医学伦理学教学中影视作品的应用可采取素材式或总结式。适当应用影视作品，能使医学伦理学教学凸显实效性、突出针对性、增强互动性。应用过程中，要注意教师角色的多重性，尊重学生的主体性，选择适宜适量的影视作品。     

在人体解剖学PBL教学中教师的角色行为探讨

为培养创造型、实用型医学人才,结合实践介绍了在人体解剖学教学中进行以PBL教学模式为核心教学改革的做法.指出与传统教学模式比较,PBL教学模式要求教师角色进行根本性的转变,即教师要从传统教学中为注意的中心和知识的源头,转变为学生获得知识的指导者.     

卓越医生背景下高职医学人文素质培养现状及对策

随着社会对健康需求的不断提高以及医疗观念的转变，医学院校在人才培养过程中不仅要注重医学理论知识和技能的传授，更要强调医学人文素质的培养。通过对我校高职临床医学专业学生进行问卷调查显示，大部分学生对医学人文素质内涵认识不够，学校医学人文课程教学模式以及培养效果方面仍有欠缺，总体培养效果欠佳。在国内卓越医生教育计划实施的背景下，通过提升教师医学人文培养意识和能力，优化课程设置，建立多样化、立体化的动态医学人文素质培育模式，改革教学方法，强化临床实践对学生医学人文素质提升功能，不断提升我校临床专业学生医学人文素质培养效果。     

在实践课堂开展研究性教学提高医学生职业素养

培养学生能力、提高学生素质是教育的主要目的,教育过程中应该充分重视学生在教学过程的主体地位,发挥好教师的设计者和引导者作用,着重培养学生综合素质和创新能力。通过在医学实践课堂上开展研究性教学,培养学生的能力素质,提高学生的职业素养,增加学生在就业竞争中的竞争力。     

医学统计教学点滴体会

医学统计学是医学研究生和本科生的一门公共必修课,该学科在学生今后从事实际工作中有着十分重要的作用,是科研工作中一个重要工具。针对我校当前统计学教学中存在的一些问题及实际教学工作的体会,从学生统计思维和统计素质的培养、学生学习兴趣和求知欲的激发、教师的专业素质和教材的选择四方面加以阐述。     

浅谈CAI在医学免疫学教学应用中的利与弊

数字化时代的到来和网络世界的建构，让计算机技术广泛地渗透到了各个行业和领域，并正在产生非同寻常的影响，对于高等教育更是如此。计算机辅助教学（computerassisted instruction，CAI）是对传统教学手段的一次革命性的挑战，它彻底改变了传统教学千年以来对黑板、粉笔、书、文字教案的依赖。作为一种全新的教学手段，已得到了越来越多教师和学生的认同。我校近年来投入了大量的人力和物力建设多媒体教室，研究多媒体教学的方法，给教师和学生提供了很好的教学平台。本文就医学免疫学教学中应用CAI的一些切身感受，浅谈CAI在教学实践中的利与弊。     

留学生生理课程教学内容及方法的研究

将医学CAII课件应用于医学基础课的理论教学尤其是留学生的教学中，提高教学效率和质量，是近年来我校教学改革的热点。本文介绍了我校生理教研室在连续7年的留学生理论课教学中，通过不断实践、不断创新、不断改革，总结出了一套行之有效的全英语教学方法。该方法包括：①挑选教师，自编英语教材；②医学CAI课件的应用；③提问式和课堂测验式教学；④学生上讲台；⑤自学；该方法在提高教学质量上已显示出良好效应。     

Value of D-Dimers in patients with acute aortic dissection

Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P ＜ 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (＞0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P ＜0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P ＜ 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.     

Research of combined liver-kidney transplantation model in rats

Objective： To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods： SD rats served as both donors and recipients. 4℃ sodium lactate Ringer＇s was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava （IVC） inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results： Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion： This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.     

BLOOD PRESSURE CHANGE WITH AGE IN SALT-SENSITIVE TEENAGERS

Objective To observe blood pressure change with age in salt-sensitive teenagers whose salt sensitivity were determined by repeated testing.Methods Salt sensitivity was determined through intravenous infusion of normal saline combined with volume-depletion by oral diuretic furosemide in 55 teenagers. After five years, salt sensitivity was re-examined and subject blood pressure was followed up. Blood pressure changes in salt-sensitive teenagers were compared to that of non-salt sensitive teenagers over five years.Results After 5 years, the repetition rate of salt sensitivity determined by intravenous saline loading is 92.7%. In teenagers with salt sensitivity on the baseline, both the systolic blood pressure increments and increment rates were much higher than non-salt sensitive teenagers (12.7±12.1 mmHg vs. 2.8±5.2 mmHg, P＜ 0.01; 12.2%± 12.0% vs. 2.5% ±4.4%, P＜ 0.001,respectively). There was a similar trend for diastolic blood pressure (8.4 ± 6.4 mmHg vs. 3.7 ± 6.4 mmHg, P = 0.052; 13.2% ±10.6 % vs. 6.8%± 10.1%, P = 0.053, respectively).Conclusions Salt sensitivity determined by intravenous saline loading showed good reproducibility. Blood pressure increments with age were much higher in salt-sensitive teenagers than non-salt sensitive teenagers, especially in terms of systolic blood pressure.     

安心颗粒对急诊经皮冠状动脉介入术后生活质量影响的研究

目的：评价使用安心颗粒对急诊经皮冠状动脉介入术（PPCI）术后生活质量的影响.方法：将160例接受PPCI的急性ST段抬高型心肌梗死患者随机分为安心颗粒组（术前顿服安心颗粒8.8g,术后安心颗粒4.4 g/次,每日2次）和对照组（仅接受基础药物治疗）.所有患者均服用阿司匹林、氯吡格雷和阿托伐他汀.分别在入院时、出院前1d、出院后180 d时,应用心肌梗死多维度量表（MIDAS）、中文版SF-36评价量表对患者生活质量评分.并观察术后30 d以内的出血并发症、血小板减少症发生情况.结果：入院时和出院前1d,两组患者的心肌梗死MIDAS、SF-36量表评分比较无差异（P＞0.05）;出院后180 d时,与对照组比较,安心颗粒组MIDAS、SF-36评分明显减低（P＜0.05）;组内与入院时比较,两组出院前1d、出院后180 d时,MIDAS、SF-36评分均降低（P＜0.05）.两组患者在随访期间均无大量出血、少量出血、重度和极重度血小板减少症发生,安心颗粒组有4例、对照组有7例发生不明显出血（P＞0.05）.两组发生轻度血小板减少症的患者数比较无差异（P＞0.05）.结论：PPCI使用安心颗粒,能改善急性ST段抬高型心肌梗死患者的生活质量,且不增加出血风险.     

The comparative studies of the influences of Urapidil and Nicardipine on sino-atrial node function, atrio-ventricular node function and hemodynamics

Objective:To investigate the influences of urapidil and nicardipine on rabbit sinus function,atrio-ventricular node function and hemodynamics.Methods:Thirty-two Angora's rabbits were selected and randomly divided into four groups.U1 group:urapidil 0.25 mg/kg;U2 group:urapidil 0.5 mg/kg;N1 group:nicardipine 10 μg/kg;N2 group:nicardipine 20 μg/kg.All these medicine were administrated within 30 seconds.Measurements were taken before and after the administration of urapidil or nicardipine for the following data:mean blood pressure(MAP),heart rate(HR),sino-atrial conduction time(SACT),maximal sinoatrial recovery time(SNRTmax)corrected sinus node recovery time(CSNRT),index of sinus node recovery time(SNRTI),Wenckebach A-V conduction frequency (WB),and P-R interval.Results:Significant MAP and HR changes were identified in all of the four groups before and after administration of both urapidil and nicardipine.No significant changes could be found in the rest of the parameters.Intergroup analysis showed that SACT and CSNRT of N1 and N2 groups were shorter than those of the U2 group(P＜0.01);the MAP decreased(P＜0.01)and the HR increased drastically(P＜0.01).Conclusions:Neither urapidil(0.25 mg/kg,0.5 mg/kg)nor nicardipine(10μg/kg,20μg/kg)has any significant influence on rabbit sinus function or rabbit atrio-ventricular node function.Nicardipine could be a better choice than urapidil for parafunctional sinus node patients.     

Expression of OPGmRNA and ODFmRNA in the patients of hip fracture due to osteoporosis

Objective：To investigate the gene expression of osteoprotegerin（OPG） and osteoclast differentiation factor（ODF） in the bone tissue of patients with hip fracture due to osteoporosis. Methods：OPGmRNA and ODFmRNA in the bone tissue in 50 cases of osteoporosis sufferers（over 50 years old） with hip fracture（Observer Group） and 30 cases of hip facture sufferers with no osteoporosis（Control group） were analyzed with the Semi-Quantitative RT-PCR method. Results：The mRNA expressed of ODF, OPG were both high in the patients with hip fracture. In the control group, the expression of OPG mRNA was observed, while the expression of ODF mRNA was very slight. Conclusion：Aged patients contained all signals including OPG, ODF that are essential for inducing osteoclastogenesis and promoting bone resorption.     

The clinicopathological and immuohistochemical analysis of solid-pseudopapillary tumor of the pancreas： report of 9 cases

Objective：To investigate the clinical features, pathological characteristics and immunophenotype of solid-pseudopapillary tumor of the pancreas（SPTP）. Methods：Nine surgically treated cases of SPTP were retrospectively reviewed. Hematoxylin and Eosin（HE） staining and immunohistochemical staining were used to analyze all cases, and the general clinical data was collected. Results：Six patients were asymptomatic except for a palpable mass. Two patients complained of vague-epigastric pain. One patient appeared jaundice. The tumor was encapsulated and solid tissues alternately with cystic tissues. Histologically, the histological structure of solid portion was pseudopapillary with a fibrovascular core. Tumor cells were uniform and medium-sized which were arranged in sheets ets or nests or pseudopapillary patterns. Immunohistochemical studies demonstrated that SPTP proved positive in vimentin（9/9 cases）, AAT（9/9 cases）, NSE（9/9 cases）, ACT（7/9 cases）, CK20（2/9 cases）, CgA（1/9 cases）, S-100（3/gcases）, PR（4/gcases）, Syn（3/9 cases） and CD56（5/9cases）, negative in CEA and ER. Conclusion：SPTP is a tumor predominantly occurring in young women frequently without special symptoms. This tumor has various characteristical histological patterns with different immunophenotype.     

Dynamic Changes in Serum Estradiol and Progesterone levels in Patients of Premenstrual Syndrome with Adverse Flow of Liver-qi

Objective:To probe into the influence of changes of ovarian hormones on the pathogenesis of the specific sub-type premenstrual syndrome(PMS)and reveal partial microcosmic mechanisms of adverse flow of liver-qi.Methods:Estradiol(E2)and progesterone(P)levels in serum were determined at different phases of menstrual cycle by radioimmunoassay.Results:In the group of PMS with adverse flow of liver-qi.the secretive peak value Of E2 and P at the follicular phase significantly decreased,and the secretive peak value at the luteal phase did not come into being.Conclusions:Low E2 and P secretive peak at the follicular phase and absence of secretive peak at the luteal phase is one of the microcosmic mechanisms of PMS with adverse flow of liver-qi.One of the pathophysiologic mechanisms of specific sub-type PMS is probably the continuous low level of E2and P.     

Real-time Three-dimensional Echocardiography in Assessment of Left Ventricular and Right Ventricular Volumes

Real-time three-dimensional echocardiography (RT3DE)is a new ultrasound technique that enables dynamic threedimensional visualization and quantification of the heart in real time. Investigation of feasibility and methodology of RT3DE in determining left ventricular (LV) and right ventricular (RV) volumes, RT3DE was performed in 35 normal adults using Philips SONOS 7500 system with a 2-4 MHz matrix array transducer. The 60°×60° "pyramid" volume database was obtained and analyzed on a TomTec echo workstation. Both LV and RV volumes were calculated with four 3DE methods (i.e. apical 2, 4, 8, and 16-plane) through manually tracing ventricular endocardial borders in end diastole and end systole. Stroke volumes were then calculated. LV volume was also measured by 2DE Simpson's rule using GE VIVID 7 ultrasound machine.     

SCREENING FOR A 21-CHROMOSOME ABNORMALITY IN PREIMPLANTED EMBRYOS OF ELDERLY WOMEN

Increasing maternal age is the only etiological factor unequivocally linked to Down's syndrome in humans. The occurrence rate of newborns with Down's syndrome is about 1/220 in women over 35 years old. However, the occurrence rate in embryos fertilized in vitro, of the elder woman is unclear. Using FISH we screened the number of chromosome 21 in preimplanted embryos of 5 elderly women (average age, 38.4 years) to study the feasibility and necessity of screening trisomy 21 in embryos in patients over 35 years old at the in vitro fertilization (IVF) center.